75 15

Drug retention and safety of TNF inhibitors in elderly patients with rheumatoid arthritis

Title
Drug retention and safety of TNF inhibitors in elderly patients with rheumatoid arthritis
Author
전재범
Keywords
Rheumatoid arthritis; TNF inhibitor; Elderly; Safety; Drug retention rate
Issue Date
2016-08
Publisher
BIOMED CENTRAL LTD
Citation
BMC MUSCULOSKELETAL DISORDERS, v. 17, Page. 1-8
Abstract
Background: The concerns about the development of adverse events (AEs) in elderly RA patients as a result of age-related changes in drug metabolism and the presence of comorbid illnesses are emphasizing due to increasing prevalence of rheumatoid arthritis (RA) in old age. However, they tend to be inadequately represented in RA clinical trials because of the exclusion criteria that are commonly applied. The tolerability and safety of TNF inhibitors in elderly patients have not been also evaluated in clinical practice. This study aimed to evaluate the retention rate and safety of TNF inhibitors (TNFI) in elderly RA patients. Methods: Total 429 RA patients (838 person-years [PYs]) treated with TNFI from a retrospective biologic DMARDs registry. Patients were divided into an elderly (age ˃= 60 years) and a younger group (˂ 60 years). The drug retention rates of both groups were compared using Kaplan-Meier curves. Potential predictors of TNFI discontinuation in the elderly were examined using Cox regression analysis. The incidence rate (IR) of serious adverse events (SAEs) in the elderly group was compared to that of the young group. Results: Of the patients, 24.9 % (n = 107, 212 PYs) were in the elderly group. Regarding the retention rates of TNFI in 3 years, there was no significant difference between the elderly and younger group (p = 0.33). The major cause of discontinuation in elderly patients was AE (34.3 %), whereas that was drug ineffectiveness (41.7 %) in younger patients. Age (HR 1.09, CI 1.02-1.16) was a predictor of discontinuation, while the presence of comorbidity (HR 0.37, CI 0.15-0.91) had a protective effect against drug discontinuation in the elderly. The IR of SAEs in the elderly (6.13/100 PYs) was higher than in the younger group (5.11/100 PYs). Conclusions: The retention rate of TNFI in the elderly was comparable with that in younger patients. The major cause of discontinuation in the elderly patients was AEs, while it was drug ineffectiveness in younger patients. The IR of SAEs in the elderly was higher than in the younger patients.
URI
https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-016-1185-6https://repository.hanyang.ac.kr/handle/20.500.11754/76318
ISSN
1471-2474
DOI
10.1186/s12891-016-1185-6
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
Files in This Item:
Drug retention and safety of TNF inhibitors in elderly patients with rheumatoid arthritis.pdfDownload
Export
RIS (EndNote)
XLS (Excel)
XML


qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

BROWSE